Media on Healthcare

Saying what they don’t mean

At the end of an unusually long editorial headlined “The High Cost of Healthcare,” the November 25 New York Times dismissed the idea of publicly funded universal healthcare, which all other industrialized countries use to provide medical treatment to all of their citizens while spending much less per capita than the U.S.

Framing a public health insurance system as a sentimental lefty dream, the paper’s editorialists wrote that “deep in their hearts, many liberals yearn for a single-payer system.” But single-payer, the paper assures us, is “no panacea for the cost problem” and has “limited political support.”

Knocking down the straw man that single-payer would solve all healthcare problems isn’t much of an achievement; while advocates point out that single-payer systems in other countries cost far less than the U.S.’s profit-dominated healthcare industry, the main benefit they point to of universal health coverage is that it would provide everyone with healthcare.

But the idea of “limited political support” is worth examining, because readers might be misled into thinking that means that single-payer is unpopular. To the contrary. On the rare occasions when they’re questioned about it, the public seems to like it; asked in a September 2007 CBS poll, 55 percent of Americans preferred a single-payer system that would be administered by the government, with taxpayers footing the bill. Just 29 percent would keep things the way they are. So when the Times says single-payer lacks “political support,” they actually mean it lacks “elite support”—too bad they don’t say what they mean.

Actually, on healthcare, corporate media often say what they don’t mean. When Massachusetts announced a plan to mandate health insurance for its citizens, this was widely described as a “universal” program (Washington Post, 5/7/06; Houston Chronicle, 4/13/06; Baltimore Sun, 4/20/07). But the Massachusetts plan enacted by then-Gov. Mitt Romney was a requirement that all citizens (with some exemptions) obtain health insurance or face penalties, based on “the false assumption that uninsured people will be able to find affordable health plans,” as critics Steffie Woolhandler and David Himmel-stein noted (Atlanta Journal & Constitution, 4/7/06). “A typical group policy in Massachusetts costs about $4,500 annually for an individual and more than $11,000 for family coverage. A wealthy uninsured person could afford that—but few of the uninsured are wealthy.”

That requiring coverage is not the same as providing it ought to be obvious. But media have so muddied the conversation with indiscriminate use of the term “universal” that such basic facts are obscured. Thus a December 5 New York Times article, which commendably explained that “mandates rarely achieve 100 percent compliance,” could still refer to Massachusetts having “enacted universal coverage,” before noting, in the next sentence, that a substantial portion of the public remains uninsured. If a plan that leaves many without healthcare can be described as “universal,” perhaps the Times believes the country already has one?

Advocates of publicly funded healthcare, despite their numbers, have always faced an uphill fight in elite media where obeisance to the for-profit insurance industry is an unspoken given. (See “Healthcare Reform: Not Journalistically Viable?” Extra!, 7-8/93.) The resulting “debate” resembles the old joke about the man who looks for his keys under the lamppost—not because he dropped them there, but because that’s where the light’s better. Pundits and editorialists bemoan healthcare’s “high costs” (economic and human), but the most direct route to bringing costs down is studiously ignored, while media (and politicians) discuss more or less minor tweaks to the current system.

On at least one occasion, the New York Times did acknowledge the elephant in the living room. An April 12, 2006 article by David Leonhardt began promisingly:

To a lot of thoughtful people, the only way to fix the health insurance crisis is to get the federal government to cover everyone. Britain, Canada, Japan and a number of other rich countries do so, and they each spend less money on healthcare than this country does. They also don’t have major companies, like General Motors, flirting with bankruptcy in large part because of the cost of health benefits.

Leonhardt said such advocates have a “pretty good argument,” but with the “undeniable flaw” that they have no chance of success. Why? “Health insurers made $100 billion in profits last year, and industries of that size are just not legislated out of business.”

Were the lines always drawn so starkly, Americans would have a better chance to decide which side they’re on.